肝酶水平与2型糖尿病合并微血管病变的相关性

Correlation Between Hepatic Enzyme Levels and Microvascular Disease in Type 2 Diabetes Mellitus

目的:探讨2型糖尿病(T2DM)合并微血管病变患者血清肝酶水平的变化及与胰岛素抵抗的相关性。方法:选取T2DM合并糖尿病视网膜病变患者89例为糖尿病微血管病变的代表性人群(观察组),另设97例未合并糖尿病慢性并发症的T2DM患者为对照组,测定2组患者身高、体质量、血压、空腹血糖、空腹C肽、空腹胰岛素、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、r-谷氨酰转移酶(GGT)、胆红素、糖化血红蛋白等指标,比较2组间所测指标的差异性,并分析肝酶异常与胰岛素抵抗(IR)及各因素的相关性。结果:ALT、AST、GGT、糖化血红蛋白观察组均显著高于对照组,差异有统计学意义(P<0.05),经Pearson相关分析,ALT、AST、GGT、糖化血红蛋白与胰岛素抵抗指数(IRI)呈正相关。结论:2型糖尿病合并微血管病变患者其肝酶水平可轻度增高,肝酶异常可能与糖尿病微血管并发症发生、发展相关,且肝酶异常与胰岛素抵抗相关,肝酶异常有可能是胰岛素抵抗的一项预测因子。

Objective： To investigate the changes of serum liver enzyme levels in patients with type 2 diabetes mellitus （T2DM） combined with microvascular disease and the relationship between serum liver enzyme levels and insulin resistance. Methods： 89 cases of diabetic retinopathy in patients with T2DM were selected as the representa- tive people of diabetic retinopathy （the observation group）. Another 97 patients without chronic diabetic complica- tions of T2DM patients were selected as the control group. Indexes of two groups of patients with height, body mass, blood pressure, fasting blood glucose, fasting C peptide, fasting insulin, alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, r-glutamyl transferase （GGT）, bilirubin and glycosylated hemoglobin were tested. The dif- ferences between the two groups were compared, and the correlation between the liver enzyme abnormalities and in- sulin resistance （IR） and other factors were analyzed. Results： ALT, AST, GGT and glycosylated hemoglobin in the observation group were significantly higher than these of the control group （P〈0.05）. By Pearson correlation analysis, ALT, AST, GGT, glycosylated hemoglobin and insulin resistance index（IRI） were positively correlated. Conclu- sion： In patients with type 2 diabetes mellitus, the level of liver enzyme in patients with microvascular disease can be slightly increased. The liver enzyme abnormalities may be related to the occurrence and development of diabetic mi- crovascular complications. What＇s more, liver enzyme abnormalities are associated with insulin resistance, and liver enzyme abnormalities may be a predictor of insulin resistance.